OP0063 PSA PATIENTS RECEIVING MONOTHERAPY WITH BDMARD/TSDMARD DO NOT DIFFER IN CLINICAL PARAMETERS FROM PATIENTS RECEIVING BDMARD/TSDMARD IN COMBINATION WITH MTX - DATA FROM RABBIT-SPA
Authors: A. Regierer, D. Kiefer, G. Schett, A. Krause, P. Sewerin, A. Weiß, A. Strangfeld
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> While in RA, methotrexate (MTX) increases the efficacy of most biologic (b) and targeted synthetic (ts) disease modifying anti-rheumatic drugs (DMARDs), the situation in PSA may be substantially different. <h3>Objectives</h3> To compare clinical and patient reported baseline parameters of PsA patients starting bDMARD/tsDMARD monotherapy with those starting these treatments in combination with MTX as well as to assess the drug retention rates in the two groups. <h3>Methods</h3> RABBIT-SpA is a prospective longitudinal cohort study including axSpA and PsA patients enrolled at initiation of a new conventional or bDMARD/tsDMARD treatment. In this analysis, PsA patients newly enrolled at initiation of bDMARD/tsDMARD treatment were stratified into two groups: as monotherapy or in combination with MTX. Treatment retention was compared by drug survival analysis. <h3>Results</h3> 69% of the patients (n=833) started bDMARD/tsDMARD as monotherapy. Combination treatment with MTX was started in 31% of the patients (n=369). In 85% of the patients in the combination group, MTX had previously been given as monotherapy and treatment was then escalated with the addition of a bDMARD/tsDMARD. Baseline clinical parameters were very similar between the two groups (Table 1). No difference between the groups was found in the six different PsA domains skin, joints, dactylitis, enthesitis, nail psoriasis, and axial involvement. Only the patients´ satisfaction with tolerability of the current treatment (4 point Likert scale) was significantly better in the combination group. <h3>Conclusion</h3> Baseline clinical parameters did not differ whether a PsA patient was started on bDMARD/tsDMARDs monotherapy or MTX-bDMARD/tsDMARDs combination. Especially parameters usually taken into account for GRAPPA or EULAR treatment recommendations, such as the number of swollen or tender joints, the number of involved enthesial sites and the severity of affected skin did not differ between the two treatment groups. Also drug retention rates were very similar. It seems that in routine care, the decision to continue or stop MTX at escalation to bDMARD/tsDMARD treatment mostly depends on the subjective tolerability of the ongoing MTX treatment. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Anne Regierer Speakers bureau: BMS, Novartis, Pfizer, Roche, Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Celltrion, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., David Kiefer Speakers bureau: Abbvie, BMS, Roche, Chugai, Novartis, UCB, Sanofi, MSD, Merck, GSK, Janssen, Boehringer Ingelheim, Galapagos, Consultant of: Abbvie, BMS, Roche, Chugai, Novartis, UCB, Sanofi, MSD, Merck, GSK, Janssen, Boehringer Ingelheim, Galapagos, Grant/research support from: Novartis, Georg Schett: None declared, Andreas Krause Speakers bureau: AbbVie, BMS, Boehringer Ingelheim, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Consultant of: AbbVie, BMS, Boehringer Ingelheim, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Grant/research support from: UCB, Philipp Sewerin: None declared, Anja Weiß Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Celltrion, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Anja Strangfeld Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Janssen, Lilly, Pfizer, Roche, Sanofi, UCB., Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Celltrion, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris.